Books reviews with the occasional interview thrown in for good measure

‘Incomprehensibility has an emormous power over us in illness, more legitimately perhaps than the upright will allow’ – ‘On Being Ill’ by Virginia Woolf & ‘Notes From Sick Rooms’ by Julia Stephen

Both of these essays have been published before but surprisingly, this is the first time they have been published together. Paris Press has lovingly put together what should become a definitive volume with Hermione Lee’s original introduction to ‘On Being Ill’. An afterword to the entire volume, written by Rita Charon (internist and literary critic) is particularly effective in drawing conclusions on the book as whole. After all, it is the book as a whole which offers a full and rich statement on the multi-faceted nature of illness, whether as carer or sufferer.

The first essay, Woolf’s ‘On Being Ill’ deserves to be up there with ‘A Room of Her Own’ and ‘Mr. Bennett and Mrs. Brown’ as a definitive artistic and philosophic statement. To be honest, it is not at all surprising that one of the best Modernist writers, who felt so keenly the arbitrary nature of such binary oppositions, would recognise that being ill destroyed any easy delineation between body and mind. She begins by lamenting the Cartesian nature of her time: ‘literature does its best to maintain that its concern is with the mind; that the body is a sheet of plain glass through which the soul looks straight and clear’ (p. 4). From this philosophical standpoint and in beautiful, lyrical prose, she speaks of being sick as a private, unique and ultimately transformative experience. From observing the skies to poetic language, a kind of understanding is accessed which is all too easily passed by in health:

‘Incomprehensibility has an emormous power over us in illness, more legitimately perhaps than the upright will allow’ (p. 21).

It becomes obvious that Woolf knew that illness had a lot to tell us and yet, while the practice of medicine has long understood illness to the extent that it continually made progress with prevention and treatment, little time has been given to considering the inner life of the patient. Being able to read Julia Stephen’s ‘Notes from Sick Rooms’ directly after Woolf’s essay in one book, you are reminded of this fact more than ever. Because despite Stephen’s complete consideration for the patient’s dignity and comfort, her patient is an archetype, a concept, to be approached and considered in exactly the same way. There is a certain uniform nature to illness here, shored up by Stephen’s desire for quantifiable clarity: ‘I have taken pains to note down things which have come under my actual observations’ (p. 51). Whilst a great deal of her practical advice is so well considered to remain relevant and useful even today, her ability to understand the patient only goes so far. Woolf challenges the limitations of her mother’s knowledge by illuminating the unknown mental and psychological terrain the patient finds themselves in:

‘There is nothing ready made for him. He is forced to coin words himself, and taking his pain in one hand, and a lump of pure sound in the other (as perhaps the people of Babel did in the beginning), so to crush them together that a brand new word in the end drops out’ (p. 7)

For Woolf, illness holds the possibility of creation. It becomes a rebellion, an inconvenient truth uttered by those who ‘cease to be soldiers in the army of the upright’ (p. 12). This stunning line captures perfectly the entire thrust of the essay where Woolf wrenches the meaning of illness from the healers to the sufferers, insisting on a kind of epistemological agency for those in society considered without agency.

This idea seems as radical today as it must have done then. Rather than just pushing illness as far away from consciousness as possible, Woolf is, in effect, championing the individual voice and experience that comes from being sick. That is not to say that Woolf’s essay is diametrically opposed to that of her mother’s. Stephen’s ‘Notes from Sick Rooms’ is painstakingly attentive to the discomforts of illness; whether obvious or not so obvious, she takes it very seriously. Her notes on all aspects of caregiving reveal a deeply humanist approach which is concerned, above all, with listening to the patient and affording them a great respect. Her essay leaves you with the impression that you could do a lot worse than be nursed by Julia Stephens. And her writing becomes unexpectedly comic when writing about the ‘tyranny’ of crumbs in the bed; it will ring so true to anyone who has tried to eat toast in bed.

Ultimately through, Woolf and Stephens are coming from very different places. Stephens looks to practical tips on nursing to tame illness; Woolf suggests that there is value in drawing it closer, breathing it in, learning it’s every curve. As Rita Charon writes in her excellent afterword:

‘Mother and daughter disagree about knowability. The mother asserts that the ill Person is knowable down to her toes…The daughter asserts that no patient is like any other patient. No predictions can be made on the basis of the evidence from others’ experience. The experience of illness cannot be generalised (p. 113).’

Any Cop?: There is no doubt that this work will continue to be more and more relevant as the scope for medical humanities and illness memoirs increases. But this book is not just important from a literary point of view. At a time when disability cuts affect the most vulnerable in society, this book reminds us not only of the universal right to respect and dignity, but also, that the voice of the sick and disabled are important and vital. If those of us without such experiences stop listening, it will only be to society’s detriment.